活体肝移植术后肝静脉淤血的MSCT灌注研究  

Hepatic Venous Congestion after Living Donor Liver Transplantation：Multi--slice Spiral CT Perfusion Study

作　　者：季倩[1] 沈文[1] 褚志强[2] 祁吉[1] 

机构地区：[1]天津市第一中心医院天津市影像医学研究所放射科,天津300192 [2]天津市第一中心医院天津市影像医学研究所移植外科,天津300192

出　　处：《实用放射学杂志》2010年第5期673-677,共5页Journal of Practical Radiology

摘　　要：目的 利用MSCT灌注成像评价活体肝移植（LDLT）术后肝静脉淤血区及非淤血区的血流动力学改变.方法 22例在本院移植外科施行活体右半肝移植的供、受者纳入本研究,所有受试者均于术后早期（1月以内）进行MSCT平扫、增强及灌注检查,同期纳入10例健康志愿者作为对照组.记录并比较对照组及LDLT术后肝静脉淤血区和非淤血区肝实质的肝血容量（BV）、血流量（BF）、平均通过时间（MTT）、表面通透性（PS）和肝动脉指数（HAF）.结果 8例供、受者（36.36%）LDLT术后早期出现肝静脉淤血.与对照组相比,淤血区肝实质BV、BF和HAF升高,具有统计学意义（P〈0.05）,MTT和PS差异没有统计学意义（P〉0.05）.非淤血区与对照组肝实质之间各项灌注参数差异均无统计学意义（P〉0.05）.淤血组与无淤血组非淤血区肝实质之间BV、BF、MTT、PS和HAF差异均无统计学意义（P〉0.05）.结论 MSCT灌注成像可对肝移植术后肝血流动力学进行检测.Objective To evaluate the hemodynamic changes of hepatic venous congestive areas and non-congestive areas after liver transplantation by using MSCT perfusion imaging. Methods 22 cases （donors and recipients） were included in this study,all subjects underwent non-contrast,contrast MSCT and CT perfusion examinations at early stage（before 1 month） after liver transplantation. At the same time, 10 healthy volunteers were included as controls. Blood volume（BV）, blood flow（ BF）, mean transit time （MTT）, permeability surface（ PS） and hepatic arterial fraction（HAF） of liver in controls, congestive areas and non-congestive areas after liver transplantation were recorded and compared,respectively. Results 8 donors and recipients （ 36.36 % ） had hepatic venous congestion（ HVC） at early stage after operation. In comparison with controls, BV,BF and HAF in congestive areas were significantly increased （P〈0.05） , while there were no abnormal hemodynamic changes in areas other than congestion in HVC patients （P 〉0.05）. There were no significant difference between non-congestive areas and controls （P〉0.05）. Conclusion The hemodynamics of liver can be evaluated by MSCT perfusion imaging in the patients undergo liver transplantation.

关 键 词：肝 肝移植 肝静脉淤血 体层摄影术 X线计算机 灌注成像 

分 类 号：R575[医药卫生—消化系统] R814.42[医药卫生—内科学]